MEDICARE: PSYCHIATRIC CARE GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1205782513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHIATRIC CARE GROUP LLC

Provider Business Mailing Address
First Line	:	7901 4TH ST N # 32023
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	515-654-6422
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 OFFICE PARK RD STE 221
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265-2548
Country	:	US
Telephone Number	:	515-654-6422
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELANIE KIM GRAMLING
Credential	:	ARNP, PMHNP-BC
Telephone Number	:	515-654-6422

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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